Neurosurgeons at St. Louis Children's Hospital and Washington University School of Medicine in St. Louis are renewing calls for a ban on use of all-terrain vehicles (ATVs) by children under age 16 after a 10-year review of injuries caused by the vehicles.
"Children have no experience or training in driving motorized vehicles, and they're driving them on uneven terrain where they can't see what's coming up ahead of them very well," says T.S. Park, M.D., the Shi Hui Huang Professor of Neurological Surgery at the School of Medicine and pediatric neurosurgeon-in-chief at St. Louis Children's Hospital. "This is leading to an increasing number of fatalities and devastating injuries with lifelong consequences for children and their parents."
Park and colleagues reviewed all cases seen at the hospital over a 10-year span, identifying 185 patients admitted as a result of ATV-related accidents. Among the study's findings:
* One-third of the patients suffered serious neurological injuries including cerebral hemorrhages and skull fractures.
* Two-thirds of the total patient population had to undergo inpatient rehabilitation.
* Two patients had spinal cord injuries.
* Two patients died.
The review was published in a July 2006 pediatric supplement to the Journal of Neurosurgery.
The study found twice as many males as females suffered neurological injuries. Patients included both riders and drivers, and their ages ranged from 2 to 17 years. Many of the injured did not wear helmets, according to Park.
"In Missouri, there are currently very few regulations on children's use of ATVs," Park notes. "No training or licensing is required. The law states only that children who drive must be a minimum of 16 years old, and that any riders 18 or under must wear helmets. In many cases even these minimal regulations are being ignored. This must change."
In their paper, Park and his colleagues point out that from the time of the ATV's introduction in 1971 to 1987, the vehicles caused an estimated 239,000 injuries and 600 deaths. An estimated 40 percent of all ATV-related deaths are children.
As further evidence of the dangers posed by ATVs, Park notes that the U.S. Consumer Product Safety Commission estimated that ATV-related accidents led to 125,500 visits to emergency departments in 2003. That made 2003 the second consecutive year that ATV-related injuries set a record.
According to the Children's Safety Network, one-third of all ATV-related fatalities occurred in children under 16 years of age, and 80 percent of those fatalities were caused by head and spine injuries.
Both figures are available online in a National Ag (Agriculture) Safety Database report on ATV safety (http://www.cdc.gov/nasd/docs/d001801-d001900/d001826/d001826.html). The database is part of the National Institute for Occupational Safety and Health, which in turn is a branch of the Centers for Disease Control and Prevention.
To reduce the increasing rates of serious injury and death from ATV-related accidents, Park and his colleagues strongly recommend new legislation crafted along guidelines previously proposed by the American Academy of Pediatrics. Those guidelines include:
* Banning children younger than 16 from riding ATVs.
* Mandatory helmet laws.
* Mandatory instruction and certification programs for ATV operators.
* Prohibiting ATVs from public streets and highways.
Park also recommends a mandatory recall of all three-wheeled ATVs. Four-wheeled ATVs are dangerously unstable, but three-wheeled ATVs are even more unstable, Park notes.
Mangano FT, Menendez JA, Smyth MD, Leonard JR, Narayan P, Park TS. Pediatric neurosurgical injuries associated with all-terrain vehicle accidents: a 10-year experience at St. Louis Children's Hospital. Journal of Neurosurgery: Pediatrics 2006 Jul;105(1 Suppl):8-15.
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